参麦注射液对心脏骤停后综合征心肌损伤及血流动力学的影响  

Effect of Shenmai Injection on myocardial injury and hemodynamics in post-cardiac arrest syndrome

作　　者：李璐 宋麦芬[2] 王振裕[1] 冯耀辉[1] 王旭升[2] LI Lu;SONG Mai-fen;WANG Zhen-yu;FENG Yao-hui;WANG Xu-sheng(Department of Health Care for Cadres,Bejing Hospital of Traditional Chinese Medicine Afiliated to the Capital Medical University,Beijing 100010,China;Department of Critical Care Medicine,Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical University,Beijing 100010)

机构地区：[1]首都医科大学附属北京中医医院干部保健科,北京100010 [2]首都医科大学附属北京中医医院重症医学科,北京100010

出　　处：《北京中医药》2023年第9期943-947,共5页Beijing Journal of Traditional Chinese Medicine

基　　金：北京市科协青年人才托举项目(BYESS2021061)。

摘　　要：目的观察参麦注射液对心脏骤停后综合征患者心肌损伤及血流动力学的影响。方法采用回顾性研究的方法,根据病程中是否使用参麦注射液分为治疗组与对照组。对照组予常规治疗,治疗组在常规治疗基础上,予参麦注射液100 mL静脉滴注,2次/d,存活患者持续使用7 d。比较2组治疗前后平均动脉压(MAP)、乳酸(Lac)、尿量、左室舒张末期内径(LVDD)、左室射血分数(EF)、脑钠肽(BNP)、高敏肌钙蛋白I(hscTnI)、肌酸激酶(CK)、肌酸激酶同工酶-MB(CK-MB)、谷草转氨酶(AST)、肌红蛋白(MYO)、乳酸脱氢酶(LDH)变化。比较2组患者APACHEⅡ评分、SOFA评分及14 d生存情况。结果治疗组患者APACHEⅡ评分、SOFA评分均低于治疗前,差异有统计学意义(P<0.01);治疗组LVDD、EF较治疗前改善,差异有统计学意义(P<0.05)。治疗组患者EF高于对照组,差异有统计学意义(P<0.05);与治疗前比较,2组患者MAP明显升高,Lac明显下降,差异有统计学意义(P<0.05),治疗组尿量明显增加,差异有统计学意义(P<0.05)。治疗后,治疗组MAP、尿量水平均明显高于对照组,差异有统计学意义(P<0.01);治疗组hscTnI水平较治疗前明显下降,差异有统计学意义(P<0.01)。治疗组患者CK、CK-MB、LDH、AST、MYO水平均较治疗前显著下降,明显低于对照组,差异有统计学意义(P<0.05,P<0.01)。对照组患者CK水平较治疗前下降,差异有统计学意义(P<0.05)。治疗组患者应用多巴胺、去甲肾上腺素剂量较治疗前减少,差异有统计学意义(P<0.05)。结论参麦注射液对心脏骤停后综合征患者的预后产生积极的影响,可维持血流动力学稳定,减轻心肌损伤,改善预后。Objective To explore the impact of Shenmai Injection on myocardial injury and hemodynamics in patients with post-cardiac arrest syndrome.Methods A retrospective study method was adopted in the study,and the patients were divided into a treatment group and a control group according to whether Shenmai Injection was used during the course of the disease.On the basis of conventional treatment,the treatment group received 100 mL of Shenmai Injection intravenously twice a day,and the surviving patients persistently received it for 7 days.The control group received conventional treatment.Survivors continued to receive it for 7 days.The changes in the mean arterial pressure(MAP),lactic acid(Lac),urine output,left ventricular end-diastolic diameter(LVDD),left ventricular ejection fraction(LVEF),brain natriuretic peptide(BNP),high-sensitivity troponin I(hscTnI),creatine kinase(CK),creatine kinase isozyme-MB(CK-MB),aspartate aminotransferase(AST),myoglobin(MYO),and lactate dehydrogenase(LDH)were compared between the two groups before and after treatment.The APACHE II scores,SOFA scores,and 14-day survivals of the two groups of patients were compared between the two groups.Results The APACHE II scores and SOFA scores of patients in the treatment group after treatment were lower than those before treatment,and the differences were statistically significant(P<0.01);The LVDD and LVEF of the treatment group were improved compared with those before treatment,and the differences were statistically significant(P<0.05);The LVEFs of treatment group were higher than those of the control group,and the differences were statistically significant(P<0.05).Compared with that before treatment,MAPs of patients in the two groups increased significantly and Lacs decreased significantly,and the differences were statistically significant(P<0.05).The urine outputs of the treatment group increased significantly,and the differences were statistically significant(P<0.01);after treatment,the MAP and urine output levels of the treatment group were sign

关 键 词：心脏骤停后综合征 心肌损伤 参麦注射液 血流动力学 

分 类 号：R259[医药卫生—中西医结合]